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https://www.readbyqxmd.com/read/28327433/sonographic-prediction-of-outcome-of-vacuum-deliveries-a-multicenter-prospective-cohort-study
#1
Birgitte H Kahrs, Sana Usman, Tullio Ghi, Aly Youssef, Erik A Torkildsen, Elsa Lindtjørn, Tilde B Østborg, Sigurlaug Benediktsdottir, Lis Brooks, Lotte Harmsen, Pål R Romundstad, Kjell Å Salvesen, Christoph C Lees, Torbjørn M Eggebø
BACKGROUND: Safe management of the second stage of labor is of great importance. Unnecessary interventions should be avoided and correct timing of interventions focused. Ultrasound assessment of fetal position and station has a potential to improve the precision in diagnosing and managing prolonged or arrested labors. The decision to perform vacuum delivery is traditionally based on subjective assessment by digital vaginal examination and clinical expertise and there is currently no method of objectively quantifying the likelihood of successful delivery...
March 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#2
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#3
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319122/can-a-simulation-based-training-program-impact-the-use-of-evidence-based-routine-practices-at-birth-results-of-a-hospital-based-cluster-randomized-trial-in-mexico
#4
Jimena Fritz, Dilys M Walker, Susanna Cohen, Gustavo Angeles, Hector Lamadrid-Figueroa
BACKGROUND: In Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness. OBJECTIVE: To perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births...
2017: PloS One
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#5
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28316966/bilateral-femoral-neck-stress-fracture-presented-with-unilateral-symptoms-in-a-shipman-laborer-a-case-report
#6
Asep Santoso, Sang-Don Joo, Dong-Hyun Lee, Young-Jun Seol, Kyung-Soon Park, Taek-Rim Yoon
Femoral neck stress fracture occured commonly in athlete and military recruit populations, some of them are bilateral. Bilateral femoral neck stress fracture that associated with other occupation is very uncommon. We report a bilateral femoral neck stress fracture case that presented with unilateral symptoms in a male shipman laborer. The patient was successfully treated conservatively. Stress fracture sometimes occur associated with an unexpected specific occupation. Consideration of bilateral involvement is highly important in managing stress fracture...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316849/spontaneous-pneumomediastinum-in-labor
#7
Mohamed Adnane Berdai, Said Benlamkadem, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman's syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman's syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28315852/characteristics-and-management-of-mirror-syndrome-a-systematic-review-1956-2016
#8
Sabah Allarakia, Hassan A Khayat, Moyassar M Karami, Abdulaziz M Aldakhil, Ahmed M Kashi, Abdulrahman H Algain, Mohammad A Khan, Loai S Alghifees, Raed E Alsulami
OBJECTIVES: To describe the clinical features of mirror syndrome and to correlate the effects of different treatments with the fetal outcomes. DATA SOURCES: Online search up to May 2016 was conducted in the PubMed, Embase (Ovid platform) and clinicalTrials.gov without restrictions of language, date or journal. Only papers providing both fetal and maternal presentations and outcomes were included. RESULTS: The study included 74 papers (n=111), with an additional two patients diagnosed at our center (n=113)...
March 20, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28301484/health-facility-service-availability-and-readiness-for-intrapartum-and-immediate-postpartum-care-in-malawi-a-cross-sectional-survey
#9
Naoko Kozuki, Lolade Oseni, Angella Mtimuni, Reena Sethi, Tambudzai Rashidi, Fannie Kachale, Barbara Rawlins, Shivam Gupta
This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care...
2017: PloS One
https://www.readbyqxmd.com/read/28301207/second-opinion-review-of-breast-imaging-at-a-cancer-center-is-it-worthwhile
#10
Kristen Coffey, Donna D'Alessio, Delia M Keating, Elizabeth A Morris
OBJECTIVE: Second-opinion review of breast imaging studies can be a time-consuming and labor-intensive process. The purpose of this investigation was to determine whether reinterpretation of studies obtained at institutions outside a cancer center influences clinical management, specifically by revealing additional cancer and preventing unnecessary biopsy. MATERIALS AND METHODS: A review was conducted of breast imaging studies of 200 patients who underwent ultrasound and MRI at community facilities and had the images submitted for second opinions at a cancer center between January and April 2014...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28298774/a-survey-on-awareness-about-the-role-of-anesthesia-and-anesthesiologists-among-the-patients-undergoing-surgeries-in-a-tertiary-care-teaching-women-and-children-hospital
#11
Vinay Marulasiddappa, H N Nethra
BACKGROUND: Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28297437/implementation-and-evaluation-of-a-protocol-management-system-for-automated-review-of-ct-protocols
#12
Joshua Grimes, Shuai Leng, Yi Zhang, Thomas Vrieze, Cynthia McCollough
Protocol review is important to decrease the risk of patient injury and increase the consistency of CT image quality. A large volume of CT protocols makes manual review labor-intensive, error-prone, and costly. To address these challenges, we have developed a software system for automatically managing and monitoring CT protocols on a frequent basis. This article describes our experiences in the implementation and evaluation of this protocol monitoring system. In particular, we discuss various strategies for addressing each of the steps in our protocol-monitoring workflow, which are: maintaining an accurate set of master protocols, retrieving protocols from the scanners, comparing scanner protocols to master protocols, reviewing flagged differences between the scanner and master protocols, and updating the scanner and/or master protocols...
September 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28289485/pneurip-tm-a-novel-respiratory-inductance-plethysmography-monitor
#13
Tariq Rahman, Ralph Page, Christopher Page, Jean-Remy Bonnefoy, Tim Cox, Thomas H Shaffer
Objective pulmonary function (PF) evaluation is essential for the diagnosis, monitoring, and management of many pediatric respiratory diseases as seen in the emergency room, intensive care, and outpatient settings. In this paper, the development and testing of a new noninvasive PF instrument, pneuRIP(TM), which utilizes respiratory inductance plethysmography (RIP) are discussed. The pneuRIP(TM) hardware includes a small circuit board that connects to the RIP bands and measures and wirelessly transmits the band inductance data to any designated wirelessly connected tablet...
March 2017: Journal of Medical Devices
https://www.readbyqxmd.com/read/28284462/an-observational-study-of-agreement-between-percentage-pain-reduction-calculated-from-visual-analog-or-numerical-rating-scales-versus-that-reported-by-parturients-during-labor-epidural-analgesia
#14
E Pratici, S Nebout, N Merbai, J Filippova, D Hajage, H Keita
BACKGROUND: This study aimed to determine the level of agreement between calculated percentage pain reduction, derived from visual analog or numerical rating scales, and patient-reported percentage pain reduction in patients having labor epidural analgesia. METHODS: In a prospective observational study, parturients were asked to rate their pain intensity on a visual analog scale and numerical rating scale, before and 30min after initiation of epidural analgesia...
February 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28283828/risk-factors-and-peripartum-outcomes-of-failed-epidural-a-prospective-cohort-study
#15
Carmen Bucstain, Gali Garmi, Noah Zafran, Sivan Zuarez-Easton, Julia Carmeli, Raed Salim
PURPOSE: Awareness to rate, risk factors, and the associated peripartum outcomes of failed epidural analgesia (FEA) may improve expectations and labor management. We aimed to identify risk factors for FEA and to examine peripartum outcomes associated with failure. METHODS: A prospective cohort study conducted between March 2015 and August 2015, at a single university medical center. Laboring women at ≥34 weeks, receiving epidural analgesia, were eligible. Pain was evaluated using a 0-10 cm visual analogue scale (VAS)...
March 10, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28282778/the-effects-of-umbilical-cord-entanglement-upon-labor-management-and-fetal-health-retrospective-case-control-study
#16
Nuriye Buyukkayaci Duman, Senay Topuz, Mehmet Omer Bostanci, Umit Gorkem, Derya Yuksel Kocak, Cihan Togrul, Tayfun Gungor
OBJECTIVE: This retrospective study aimed at determining prognostic factors that paved the way for umbilical cord entanglement (UCE) and the effects of UCE upon labor management and fetal health. METHODS: Sixty women who gave term birth with head presentation and received UCE diagnosis following birth composed the case group while another 60 women with the same characteristics who were selected with randomized sampling method and who did not develop UCE comprised the control group...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28282777/comparing-the-effect-of-e-learning-and-educational-booklet-on-the-childbirth-self-efficacy-a-randomized-controlled-clinical-trial
#17
Parastoo Abbasi, Sakineh Mohammad-Alizadeh Charandabi, Mojgan Mirghafourvand
PURPOSE: This study aimed to compare the effect of e-learning and educational booklet on the childbirth self-efficacy (CBSE). METHODS: This randomized controlled clinical trial was conducted on 153 pregnant women referred to health centers in the city of Miandoab, Iran in 2015-2016. Participants were assigned into two intervention groups (e-learning and educational booklet) and the control group. A single face-to-face session was held for intervention groups about the management of labor pain in 30-34 weeks of pregnancy and the booklet and software were provided...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277909/late-preterm-and-early-term-when-to-induce-a-growth-restricted-fetus-a-population-based-study
#18
Alex Rabinovich, Tehila Tsemach, Lena Novack, Moshe Mazor, Tal Rafaeli-Yehudai, Orna Staretz-Chacham, Ruth Beer Weisel, Vered Klaitman-Mayer, Salvatore A Mastrolia, Offer Erez
PURPOSE: 1) Compare fetal and neonatal morbidity and mortality associated with induction of labor (IOL) vs. expectant management (EM) in women with isolated fetal growth restriction (FGR) between [Formula: see text] - [Formula: see text] weeks; 2) Determine optimal gestational age for delivery of such fetuses. MATERIALS AND METHODS: A retrospective population based cohort study of 2232 parturients with isolated FGR, including two groups: 1) IOL (n = 1428); 2) EM (n= 804)...
March 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277371/what-is-new-in-labor-management-best-articles-from-the-past-year
#19
Rebecca Dunsmoor-Su
This month, we focus on current research in labor management. Dr. Dunsmoor-Su discusses five recent publications, and each is concluded with a "bottom line" that is the take-home message. The complete reference for each can be found in Box 1 on this page, along with direct links to the abstracts.
March 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28277361/route-of-delivery-in-women-with-stillbirth-results-from-the-stillbirth-collaborative-research-network
#20
Annelee Boyle, Jessica P Preslar, Carol J R Hogue, Robert M Silver, Uma M Reddy, Robert L Goldenberg, Barbara J Stoll, Michael W Varner, Deborah L Conway, George R Saade, Radek Bukowski, Donald J Dudley
OBJECTIVE: To describe delivery management of singleton stillbirths in a population-based, multicenter case series. METHODS: We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery information was abstracted from medical records. Both antepartum and intrapartum stillbirths were included; these were analyzed both together and separately. The primary outcome was mode of delivery...
March 6, 2017: Obstetrics and Gynecology
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